Pediatric Scabies

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What is scabies?

Scabies is an infestation of mites (tiny insects) characterized by small red bumps and intense itching. This highly contagious infection often spreads from person to person while they are sleeping together in the same bed or have close personal contact.

The itching is caused by the mites burrowing into the skin where they lay eggs that hatch a few days later. Scabies can affect people of all ages. Scabies occurs mostly in children and young adults.

What are the symptoms of scabies?

It may take between 4 to 6 weeks for a child to develop symptoms of scabies after coming in contact with an infected person.

In children younger than 2 years of age, the lesions caused by the mites tend to occur on the head, neck, palms, and soles. In older children, the lesions are usually between the fingers, on the hands or wrists, along the belt line, on the thighs or belly button, in the groin area, around the breasts, and in the armpits.

The following are the most common symptoms of scabies. However, each child may experience symptoms differently. Symptoms may include:

Itching, usually severe

Rash, with small pimples or red bumps

Scaly or crusty skin (with advanced conditions)

How is scabies diagnosed?

In diagnosing scabies, the skin and skin crevices are examined by a physician. A sample of skin, obtained by scraping the skin, may be examined under a microscope to confirm the presence of mites.

What is the treatment for scabies?

Scabies is treatable and usually all members in a family are treated at the same time. Specific treatment will be determined based on:

The child's age, overall health, and medical history

Extent of the infestation

The child's tolerance for specific medications, procedures, or therapies

Expectations for the course of the infestation

Child or parent’s opinion or preference

Treatment may include:

Applications of prescription creams and lotions, such as permethrin and lindane solutions

Oral antihistamine medication (to help relieve itching)

In some cases, topical ointments are recommended

In addition, it is important to wash all clothes and bedding in hot water and dry in a hot dryer in order to kill the mites. Clothing and other objects that cannot be washed (i.e., pillows, stuffed animals) should be placed in a plastic bag for at least one week.

Also, the itching may continue for many weeks after the initial treatment of the scabies.

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The Division of Dermatology at Children's National Health System continues to expand services as more families seek our expertise in the diagnosis and treatment of disorders of the skin, hair, and nails.